BACKGROUND: With the understanding of pathology of cervical diseases, cervical curvature has become one of
the important indexes of long-term clinical outcome. To restore and maintain cervical curvature has a profound impact on cervical long-term stabilization and cervical biomechanical environment.
OBJECTIVE: To evaluate long-term influence of selective consecutive three-level appliance of intervertebral Solis cage on cervical curvature for spondylotic myelopathy.
METHODS: From June 2008 to December 2010, 22 spondylotic myelopathy patients were treated with
consecutive three-level anterior cervical Solis fusion. There were 14 males, 8 females, with an average age of
45.1 years (ranged from 26-73 years). There were two cases of C2/3/4/5, seven cases of C3/4/5/6, 12 cases of C4/5/6/7, and one case of C5/6/7/T1 , total y 66 intervertebral spaces. Al cases were fol owed up for 2 years.
RESULTS AND CONCLUSION: Average blood loss amount was 40 mL (20-80 mL). Average operation time was 121 minutes (100-175 minutes). After fol ow-up for 30.7 months, al segments were fused. There was no implant migration or vertebral body col apse. Pre-operative JOA score was 11.94±3.61, 15.56±1.13 at 6 months post-operation, and 15.21±1.85 at 2 years after implantation. Pre-operative cervical curvature was (1.86±3.24) mm,(4.83±1.78) mm at 6 months post-operation, and (4.44±3.36) mm at 2 years after implantation. There were significant differences between pre-operative and at 6 months post-operation, pre-operative and at 2 years post-operation (P < 0.05). There was no significant difference between 6-month and 2-year post-operation (P > 0.05). Results indicated that selective consecutive three-level appliance of intervertebral cage for spondylotic myelopathy could improve cervical curvature and have long-term favorable clinical outcomes.

Objective To study the changes of corneal sensitivity in diabetic and nondiabetic subjects after phacoemulsification. Methods This trial involved 42 diabetic subjects(42eyes)and 46 nondiabetic subjects(46 eyes)with cataract.All eyes were underwent phacoemulsification.Corneal sensitivities were tested before surgery and 1 day,1 week,1 month,3 month,6 month after surgery.Results The corneal sensitivity of diabetic subjects was greatly reduced at 1 day,1 week,1 month,3 month after surgery(P＜0.05),and returned to the preoperative values at 6 month(P＞0.05).The corneal sensitivity of nondiabetic subjects was reduced at 1 day,1 week,1 month af- ter surgery(P＜0.05),and returned to the preoperative values at 3 month(P＞0.05).The corneal sensitivity of diabetic subjects was lower than nondiabetic subjects before surgery(P＜0.05).The reduced range of corneal sensitivity in diabetic subjects was greater than that of nondiabetic subjects(P＜0.05).Conclusions The corneal sensitivity is decreased and the recovery is postponed after poacoemul- sification in diabetic subjects.

Objective Through application of clinical pathway in hospitalization patients undergoing uterectomy, we aimed to study the efficacy of clinical pathway in uterectomy patients. Methods 120 patients randomly sampled into the experimental group and the control group with 60 in each. The experimental group received diagnosis, treatment, nursing and rehabilitation according to the clinical pathway table, patients in the control group received routine nursing interventions. The average hospitalization days, medical costs, patient satisfaction degree, disease cognition, first exercise time after operation and medical disputes were compared between the two groups. Results The average hospitalization days and hospitalization costs of the experimental group were obviously lower than those in the control group, patients' satisfaction degree, knowledge of health and first functional exercise time in the experimental group were better than those of the control group, while the medical disputes in the experimental group were obviously de -creased in the experimental group. Conclusions Application of clinical pathway in nursing care for uterectomy patients can effectively decrease hospitalization days, medical costs and disputes. It is also helpful for patients to cooperate with doctors in diagnosis, treatment, nursing, thus increase the satisfaction degree of patients, ensure the reasonable use of medical resources and promote the sustainable improvement of nursing quality.

Objective To investigate the effectiveness and technical points of anatomical liver resection by trans-Glisson Sheath methylene blue staining in treatment of hepatolithiasis of right posterior lobe.Methods The clinical data of 12 cases of hepatolithiasis of right posterior lobe treated with anatomical liver resection by Glisson sheath methylene blue staining were retrospectively analyzed.Result 6 of 12 patients had undergone more than 2 previous biliary surgeries.All patients underwent contrast-enhanced CT scan and portography,hepatolithiasis of segment Ⅵ in 4 cases,right posterior lobe in 8 cases,accompanied by left lateral lobe bile duct stones in 2 cases,the right caudate lobe bile duct stones in 1 case.Methylene blue was injected into the portal vein,the methylene blue interface of segment Ⅵ or right posterior lobe displays well.Methylene blue interface was larger than the ischemia interface,which is in accordance with the anatomy.Along the methylene blue interface,hepatic resection was performed including right posterior lobe resection (n =9),segment Ⅵ resection (n =3),and combined with left lateral lobe resection (n =2) and the right caudate lobe resection (n =1).There was no postoperative mortality.Incision infection occurred in 5 cases,4 had right pleural effusion and 2 had a biliary fistula that were treated conservatively.With a mean follow-up period of 3.2 years,all patients are symptoms free and stone free.Conclusions Anatomical liver resection by methylene blue staining is a safe and effective treatment for hepatolithiasis of right posterior lobe.

A rapid, sensitive and convenient LC-MS/MS method was developed for the determination of γ-aminobutyric acid (GABA) in human plasma. d2-γ-Aminobutyric acid (d2-GABA) was synthesized as internal standard (IS). After extraction from human plasma by protein precipitation with acetonitrile, all analytes were separated on a Luna HILIC column (100 mm x 3.0 mm, 3 μm) using an isocratic mobile phase of water: acetonitrile: formic acid (20 : 80 : 0.12) with a flow rate of 0.5 mL x min(-1). Acquisition of mass spectrometric data was performed in multiple reaction monitoring mode (MRM) in positive electrospray ionization using the transitions of m/z 104 --> 69 for GABA and m/z 106 --> 71 for d2-GABA. The method was linear in the concentration range of 5.00 to 1 000 ng x mL(-1). The intra- and inter-day precisions were within 9.9%, and accuracy ranged from 99.1% to 104%, within the acceptable limit across all concentrations. The method was successfully applied to a pharmacokinetic study of GABA tablets in healthy Chinese volunteers.
Chromatography, Liquid ; Humans ; Tandem Mass Spectrometry ; gamma-Aminobutyric Acid ; blood

Adult ; Ethylene Oxide ; poisoning ; Female ; Humans ; Occupational Exposure

the effect of maintaining integrity of epithelial cells by increasing occludin protein expression,and the effect is related with the up-regulation of occludin mRNA.

Familial adenomatous polyposis is characterized by the multiple and adenomatous polyps in the colorectum combined with polyps in the stomach and duodenum, while it is rarely seen in the common bile duct (CBD).In July 2013, 1patient with FAP combined with adenomas in the CBD was admitted to the Fujian Provincial Hospital.The patient underwent laparoscopic CBD exploration and resection of masses due to acute pancreatitis 11 months ago, and was confirmed as with adenoma in the distal CBD by postoperative pathological examination.Multiple polyps were found in the stomach, duodenum,CBD, colorectum after admission to hospital, biopsy confirmed that polyps were tubular adenoma.The patient received pancreaticduodenectomy and was diagnosed as with duodenum-CBD tubular adenoma in postoperative pathological examination.The patient was followed up by telephone interview and outpatient examination and had a full recovery, in addition to the increasing of stools frequency and occasioned hematochezia, and then was treated by total colectomy at postoperative month 7.The tubular adenoma was confirmed by postoperative pathological examination.

AIM:To compare the efficacy and safety of intravitreal ranibizumab to those of triamcinolone acetonide ( TA ) injection for the treatment of macular edema secondary to central retinal vein occlusion ( CRVO) .
METHODS:This retrospective study included 40 eyes of 40 patients with macular edema associated with CRVO. Twenty patients 20 eyes were treated with intravitreal injection of triamcinolone acetonide (1mg, 0. 1mL), the other 20 patients 20 eyes accepted intravitreal ranibizumab (0. 5mg, 0. 05mL). The change of best corrected visual acuity ( BCVA ) , central macular thickness ( CMT ) , and intraocular pressure ( IOP ) before treatment and at 1, 2wk, 1, 2,3,6mo post-injection in the two groups were observed.
RESULTS:BCVA was improved at 1, 2wk, 1, 2,3,6mo post-injection in the TA group (P<0.05) and ranibizumab group ( P<0. 05 ). No significant difference was found between the two groups ( P > 0. 05 ). CMT decreased significantly within each group ( P < 0. 05 ), and no significant difference between groups was found ( P >0.05). In the TA group, the IOP was significantly higher at 2wk and 4wk than before treatment (P<0. 05). In the ranibizumab group, no elevated IOP was observed at 1, 2wk, 1, 2,3,6mo (P>0. 05). However, the IOP at 1mo was significantly higher in the TA group than that in the ranibizumb group (P<0. 05).
CONCLUSION:Intravitreal ranibizumab is an effective and safe treatment method for macular edema secondary to CRVO. It can effectively improve BCVA and reduce CMT without ocular and systemic complications compared with intravitreal TA.